肾移植受者中发生的恶性肿瘤

Development of Cancer in Recipients of Renal Transplantation A Report of 4 Cases

１９７８年～１９９４年间我院共行４６９例尸体肾移植，其中４例发生了恶性肿瘤，发生率０．８５％。肿瘤分别为鼻咽癌，胰头癌，白血病和Ｋａｐｏｓｉ＇ｓ肉瘤。此４例患者移植时年龄２６～４８岁。从肾移植至发生恶性肿瘤的间隔时间为２．５～６９个月，平均３６．６个月。其免疫抑制剂除１例为硫唑嘌呤加强的松外，余３例均为硫唑嘌呤、环孢素Ａ和强的松三联治疗。３例已死亡，死亡时移植肾功能正常，１例至今无瘤存活已达１年。建议对长期存活的肾移植受者应严密观察其肿瘤的发生。

Between 1978 and 1994,469 patients underwent renal transplantation at our hospital.All these recipients recived allografts from dying human body.Of them,four cases(0.85%)developed malignant tumor,including one nasopharyngeal carcinoma,one cancer of head of pancreas,one leukemia,and one Kaposi's sarcoma.The 4 patients were 26 to 48 years of age at the time of transplantation.The mean interval between kidney transplantation and diagnosis of malignancy was 36.6(range 2.5 to 69)months.The immunosuppressive agents given to these patients were azathioprine plus prednisone in one case;Azathioprine,cyclosporin prednisone combined in three cases.Of the 4 cases,three died with functioning grafted kidndy and one is still alive without and sign of cancer recurrence.As a result,it is suggested that close surveilance for maligancies is mandatory in long-term immunosuppressed transplant recipients.